The costs between Emergency Room visits and other forms of urgent care have widened substantially and should set off alarms for health plan sponsors. The average cost of an ER visit in 2012 was over 12 times the cost of an urgent care visit, and over 19 times the cost of a walk-in retail clinic. ER visits also accounted for nearly three quarters of all emergency care. According to The Segal Group’s National Health Practice Leader Ed Kaplan, plans that experience more than 200 ER visits per 1,000 covered participants should consider offering incentives for other forms of care to help reduce the ER utilization level and ultimately save on costs for the plan and its participants.

“Adjusting member copays and improving education can reduce the amount spent on unwarranted ER visits,” commented Mr. Kaplan. “And, given the expansion of urgent care centers and walk-in clinics over the last few years, promoting a higher level of awareness about the availability of alternative forms of urgent care will help participants make better decisions about where the best place might be to get the care they need.”

For more information or to speak with Mr. Kaplan, please contact Todd Kohlhepp.